A senior nurse representing the UK at an international nursing event has said she feels “ashamed” of the role the country has played in the exploitation of internationally educated nurses in recent years.
Professor Nicola Ranger, chief executive and general secretary of the Royal College of Nursing (RCN), made the comment at the 2025 International Council of Nurses (ICN) Congress, being held in Helsinki, Finland this week.
“We’ve had direct examples of shocking exploitation of some of our international nurses”
Nicola Ranger
Speaking at the Council of Nursing Associations (CNR), a forum for ICN member countries to discuss and vote on resolutions, Professor Ranger said she felt there had not been enough discussion on how to tackle the issue of international recruitment.
The UK, over the past decade, has recruited thousands of registered nurses from overseas to fill workforce shortages.
A not-insignificant number of these nurses have been from countries that are less developed than the UK, or which themselves are facing acute shortages of nursing staff.
Some of these countries are listed on the World Health Organization (WHO)’s Global Code of Practice on the International Recruitment of Health Personnel – also known as the “red list” – as places from which active recruitment of nurses should not take place.
As well as this, there have been reports of internationally educated nurses themselves being mistreated on arrival, particularly in social care settings.
More recently, the UK has significantly curbed its international recruitment of overseas nurses.
National nursing association leaders at CNR 2025
The topic was broached at CNR; one of the recommendations agreed on by members was to lobby the WHO to strengthen its international recruitment code of practice, a call ICN president Dr Pamela Cipriano supported.
Professor Ranger said, however, that she felt CNR had been a “missed opportunity” to deal with exactly how to tackle the issue of exploitative international recruitment.
She said: “We’ve had direct examples of shocking exploitation of some of our international nurses.”
Professor Ranger also said that she was aware of “some really poor back office deals” done between the government and countries sending nurses in recent years, where “the wellbeing of those nurses is not considered at all”.
She added: “And I would just love to have had the opportunity to discuss with my colleagues the genuine, genuine concern of exploitation of nurses from all over the world.
“And I feel very ashamed by how the UK is sometimes behaving in this way.”
While worried about exploitative practices, she also raised concern about the fact that the UK had “almost stopped overseas recruitment in the past two months overnight” and the impact this may have on countries.
“Many of us come from places [in which] we’re not proud of some of the things that are happening”
Pamela Cipriano
“I, personally, am very worried about the economic instability that would have created in some of those countries,” she added.
Professor Ranger welcomed the findings of the second State of the World’s Nursing report, which was published last month and presented to CNR by ICN chief executive Howard Catton.
The report supported calls to strengthen the WHO’s code of conduct.
In response to Professor Ranger, Mr Catton said he hoped further discussions at ICN Congress this week would be had on this matter.
He added: “I sense that whilst we now have more of a consensus saying [WHO’s code of conduct] needs more teeth, [that] it needs to be strengthened – what those teeth look like in policy terms isn’t so clear.
“So, I think there is an opportunity for us as a community to do more work, to lead this discussion, to say, ‘this is how we think it should be strengthened, this is how we think, in practice, ethical recruitment could work’.”
Dr Cipriano said ICN was “committed” to pushing for a strengthened WHO code of conduct, and for more “mutuality” in agreements for international recruitment.
The ICN president, whose term in the post ends on Friday, told Professor Ranger: “Thank you for revealing your concerns about the actions within your country.
“Many of us come from places [in which] we’re not proud of some of the things that are happening. So thank you.”
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